Ukuphumelela Kwezifo Ezizenzakalelayo Zezingane: I-CAR-T Cell Therapy Yelapha Isiguli Se-Lupus

NgoJuni 2023, u-Uresa oneminyaka engu-15 ubudala wathola ukwelashwa kwamaseli e-CAR-T esibhedlela sase-Erlangen University, okumaka ukusetshenziswa kokuqala kwalokhu kwelashwa okusha ukuze kubambezeleke ukuqhubeka kwe-systemic lupus erythematosus (SLE), isifo esinzima sokuzivikela komzimba. Ngemva konyaka, u-Uresa uzizwa enempilo njengakuqala, ngaphandle kwemikhuhlane embalwa emincane.

U-Uresa uyingane yokuqala elashelwa i-SLE nge-immunotherapy e-German Center for Immunotherapy (DZI) yase-Erlangen University. Impumelelo yalokhu kwelashwa komuntu ngamunye kushicilelwe ku-Lancet.

UDkt. Tobias Krickau, udokotela wamathambo ezingane e-Erlangen University Hospital's Department of Pediatrics and Adolescent Medicine, wachaza ukuhluka kokusebenzisa amaseli e-CAR-T ukwelapha izifo ezizimele. Ngaphambilini, ukwelashwa kwe-CAR-T kwakugunyazwe kuphela umdlavuza wegazi othile oseqophelweni eliphezulu.

Ngemuva kokuthi yonke eminye imithi yehlulekile ukulawula i-SLE eyandayo ye-Uresa, ithimba labacwaningi labhekana nesinqumo esiyinselele: ingabe lawa mangqamuzana okuzivikela omzimba akhiwe kufanele asetshenziselwe ingane enesifo esizimele? Impendulo yayingakaze ibonwe ngaphambili, njengoba kungekho noyedwa owake wazama ukwelashwa nge-CAR-T ezifweni ze-autoimmune zezingane ngaphambilini.

Ukwelashwa kwamaseli e-CAR-T kuhilela ukukhipha amanye amaseli omzimba esiguli (T cell), ukuwahlomisa ngama-chimeric antigen receptors (CAR) elebhu ekhethekile ehlanzekile, bese ebuyisela la maseli ashintshiwe esigulini. Lawa maseli e-CAR-T ajikeleza egazini, aqondise futhi abhubhise ama-B cell asebenzayo (ayingozi).

Izimpawu zika-Uresa zaqala ekwindla ka-2022, okuhlanganisa ukudumala kwekhanda, ukukhathala, ubuhlungu bamalunga nemisipha, nokuqubuka kobuso—izimpawu ezivamile ze-lupus. Naphezu kokwelashwa okuqinile, isimo sakhe saba sibi kakhulu, sathinta izinso futhi sabangela izinkinga ezinkulu.

Ekuqaleni kuka-2023, ngemuva kokulaliswa esibhedlela kanye nokwelashwa kaningi, okuhlanganisa i-immunosuppressive chemotherapy kanye nokushintshaniswa kwe-plasma, isimo sika-Uresa saba sibi kakhulu kangangokuba adinga ukuhlanza igazi. Ehlukaniswe nabangane nomndeni, izinga lakhe lempilo lehla.

Ithimba lezokwelapha e-Erlangen University, eliholwa uSolwazi Mackensen, livumile ukukhiqiza nokusebenzisa amaseli e-CAR-T e-Uresa ngemva kwezingxoxo ezinemininingwane. Lokhu kusetshenziswa kozwela kokwelashwa kwe-CAR-T kwaqalwa ngaphansi komthetho waseJalimane wezidakamizwa kanye nemithethonqubo yokusetshenziswa enesihawu.

Uhlelo lwe-CAR-T cell therapy e-Erlangen, oluholwa nguSolwazi Georg Schett kanye noProfessor Mackensen, belaphe iziguli ezinezifo ezihlukahlukene ze-autoimmune, kuhlanganise ne-SLE, kusukela ngo-2021. Impumelelo yabo ngeziguli ze-15 yanyatheliswa ku-New England Journal of Medicine ngoFebhuwari. 2024, futhi njengamanje benza ucwaningo lwe-CASTLE nabahlanganyeli abangu-24, bonke babonisa ukuthuthuka okuphawulekayo.

Ukuze alungiselele ukwelashwa kwamaseli e-CAR-T, u-Uresa welashwa ngamakhemikhali omthamo omncane ukuze akhe isikhala samangqamuzana e-CAR-T egazini lakhe. Ngomhla zingama-26 kuJuni 2023, u-Uresa wathola amaseli akhe e-CAR-T aqondene naye. Ngesonto lesithathu ngemva kokwelashwa, ukusebenza kwezinso zakhe kanye nezinkomba ze-lupus kwaba ngcono, futhi izimpawu zakhe zanyamalala kancane kancane.

Inqubo yokwelapha yayihilela ukusebenzisana ngokucophelela ukuze kuqinisekiswe ukusebenza kahle kwe-chemotherapy kanye nokuvikelwa kokusebenza kwezinso ezisele. I-Uresa yaba nemiphumela engemihle kuphela futhi yakhishwa ngosuku lwe-11 ngemva kokwelashwa.

Ekupheleni kukaJulayi 2023, u-Uresa wabuyela ekhaya, waphothula izivivinyo zakhe, futhi wazibekela imigomo emisha yekusasa lakhe, okuhlanganisa ukuzimela nokuba nenja. Wakujabulela ukuphinde ahlangane nabangane futhi aqale kabusha impilo evamile yobusha.

USolwazi Mackensen wachaza ukuthi i-Uresa isenenani elikhulu lamaseli e-CAR-T egazini lakhe, okusho ukuthi udinga ukujova ama-antibody nyanga zonke kuze kube yilapho ama-B cell akhe alulama. UDkt. Krickau ugcizelele ukuthi impumelelo yokwelashwa kuka-Uresa yabangelwa ukubambisana okuseduze kwemikhakha eminingi yezokwelapha e-German Center for Immunotherapy.

I-Uresa akasayidingi imithi noma i-dialysis, futhi izinso zakhe seziluleme ngokugcwele. UDkt. Krickau nethimba lakhe bahlela izifundo ezengeziwe zokuhlola amandla amangqamuzana e-CAR-T ekwelapheni ezinye izifo zezingane ezizimele.

Leli cala eliyingqopha-mlando libonisa amandla okwelashwa kweseli ye-CAR-T ukuhlinzeka ngokuxolelwa kwesikhathi eside ezigulini zezingane ezinezifo ezinzima zokuzivikela komzimba njenge-SLE. Impumelelo yokwelashwa kwe-Uresa igqamisa ukubaluleka kokungenelela kusenesikhathi nokusebenzisana kwemikhakha eminingi. Kudingeka olunye ucwaningo lwemitholampilo ukuze kuqinisekiswe ukuphepha nempumelelo yesikhathi eside ye-CAR-T cell therapy ezinganeni ezinezifo ezizimele.